Red Blood Cell Transfusion Condition of In-patients of Peking Union Medical College Hospital in 2010 and 2013
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摘要:
目的 初步了解2010年和2013年北京协和医院住院患者红细胞输注的概况和变化。 方法 随机抽取2010年和2013年在北京协和医院住院期间行红细胞输注的患者资料, 比较其性别、年龄、输血时所在科室、第1次红细胞输注前的血红蛋白值等临床信息。 结果 本研究纳入住院期间行红细胞输注的患者2010年为174例, 2013年为500例。住院患者红细胞输注前平均血红蛋白2010年非手术科室为(67.71±11.31)g/L, 手术科室为(78.68±15.64)g/L; 2013年非手术科室为(63.75±12.41)g/L, 手术科室为(81.53±17.09)g/L; 2010年和2013年非手术科室患者红细胞输注前血红蛋白检测率均为100%;手术科室患者2013年红细胞输注前血红蛋白检测率为68.6%, 较2010年的47.7%提高, 差异具有统计学意义(P < 0.001)。 结论 北京协和医院非手术科室和手术科室启动红细胞输注的血红蛋白阈值均符合我国与国际输血指南所推荐的范围, 体现本院对红细胞输注一贯严格把握输血指征, 用血行为合理, 并不断完善进步。 Abstract:Objective To study the general condition and changes of red blood cell transfusion in Peking Union Medical College Hospital in the years of 2010 and 2013. Methods Random sampling was conducted among the in-patients who received red blood cell transfusion during hospitalization at Peking Union Medical College Hospital in 2010 and 2013. The clinical information including gender, age, wards where transfusion was performed, and the hemoglobin values before the first red blood cell transfusion were compared between the 2 years. Results Totally, 174 cases in 2010 and 500 cases in 2013 were enrolled. The mean hemoglobin value before red blood cell transfusion in non-surgical and surgical wards were (67.71±11.31)g/L and (78.68±15.64)g/L respectively in 2010, which were (63.75±12.41)g/L and (81.53±17.09)g/L respectively in 2013. Hemoglobin detection rates in in-patients before red blood cell transfusion in non-surgical wards in 2010 and 2013 were both 100%; in surgical wards, the hemoglobin detection rate was 68.6% in 2013, significantlyhigher than that in 2010 (47.7%, P < 0.001). Conclusions In both non-surgical and surgical wards of Peking Union Medical College Hospital, the hemoglobin threshold for initiating red blood cell transfusion were in accordance with the recommendations of international and China guidelines, indicating that in our hospital, indication of red blood cell transfusion is strictly followed and transfusion administration is rational with continuous improvement. -
表 1 2010年与2013年非手术和手术科室红细胞输注患者临床状况对比
科室类型 年份 性别比(男/女) 年龄(x±s, 岁) 红细胞输注前血红
蛋白检测率(%)红细胞输注前血红蛋白
(x±s, g/L)非手术科室 2010年(n=42) 1.21 54.10±20.70 100(42/42) 67.71±11.31 2013年(n=121) 0.89 53.12±17.26 100(121/121) 63.75±12.41 统计值 t=0.031 t=1.822 P=0.764 P=0.070 手术科室 2010年(n=132) 0.85 55.60±17.25 47.7(63/132) 78.68±15.64 2013年(n=379) 0.58 56.11±16.02 68.6(260/379) 81.53±17.09 统计值 t=-0.310 χ2=18.344 t=-1.204 P=0.757 P<0.001 P=0.229 -
[1] Carson JL, Carless PA, Hebert PC. Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion[J]. Cochrane Database Syst Rev, 2012, 4:CD002042. [2] Carson JL, Terrin ML, Noveck H, et al. Liberal or restrictive transfusion in high-risk patients after hip surgery[J]. N Engl J Med, 2011, 365:2453-2462. doi: 10.1056/NEJMoa1012452 [3] Carson JL, Carless PA, Hébert PC. Outcomes using lower vs higher hemoglobin thresholds for red blood cell transfusion[J]. JAMA, 2013, 309:83-84. doi: 10.1001/jama.2012.50429 [4] Hébert PC, Carson JL. Transfusion threshold of 7 g per deciliter-the new normal[J]. N Engl J Med, 2014, 371:1459-1461. doi: 10.1056/NEJMe1408976 [5] Roubinian NH, Escobar GJ, Liu V, et al. Trends in red blood cell transfusion and 30-day mortality among hospitalized patients[J]. Transfusion, 2014, 54:2678-2686. doi: 10.1111/trf.12825 [6] Gruber-Baldini AL, Marcantonio E, Orwig D, et al. Delirium outcomes in a randomized trial of blood transfusion thresholds in hospitalized older adults with hip fracture[J]. J Am Geriatr Soc, 2013, 61:1286-1295. doi: 10.1111/jgs.12396 [7] Carson JL, Grossman BJ, Kleinman S, et al. Red blood cell transfusion:a clinical practice guideline from the AABB[J]. Ann Intern Med, 2012, 157:49-58. doi: 10.7326/0003-4819-157-1-201206190-00429 [8] Murphy MF, Wallington TB, Kelsey P, et al. Guidelines for the clinical use of red cell transfusions[J]. Br J Haematol, 2001, 113:24-31. doi: 10.1046/j.1365-2141.2001.02701.x [9] Practice Guidelines for blood component therapy: A report by the American Society of Anesthesiologists Task Force on Blood Component Therapy[J]. Anesthesiology, 1996, 84: 732-747. [10] 卫生部.临床输血技术规范[S].北京: 卫生部办公厅, 2000. [11] Hebért PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trail of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Trails Group[J]. N Engl J Med, 1999, 340:409-417. doi: 10.1056/NEJM199902113400601 -